[Acrosyringium and follicular infundibulum: immunomorphologic aspects]. / Akrosyringium und Follikelinfundibulum: Immunmorphologische Aspekte.

Acrosyringium and infundibulum are epidermal structures with different morphology, but functional similarities regarding re-epithelialization, transport of antigens, and attraction of infiltrates. Immunomorphologically, the infundibula revealed an immunoreactivity of Langerhans cells and keratinocytes comparable with that of the interfollicular epidermis, whereas the acrosyringia reacted differently because of the permanent expression of MHC class II antigens and reduced Langerhans cells in the perisyringial region. Our findings suggest that these epidermal compartments differ with regard to their individual immunologic situations. While the mechanisms of epidermal immunity known from the interfollicular epidermis are possibly the same in the infundibula, we have to expect a basically different immunologic situation in the acrosyringia.

[Characterization of lymphocytic infiltrate cells in bullous pemphigoid and pemphigus vulgaris]. / Charakterisierung lymphozytärer Infiltratzellen bei bullösem Pemphigoid und Pemphigus vulgaris.

By means of monoclonal antibodies (mab) and alkaline phosphatase anti-alkaline-phosphatase (APAAP) technique, the distribution and characteristics of lymphocytic infiltrates were studied in biopsies from 15 patients with bullous pemphigoid (b.P.) and 5 patients with pemphigus vulgaris (P.v.). The biopsies were obtained from freshly developed blisters along with perilesional tissue. The lymphocytic infiltrates in b.P. as well as in P.v. were located in the area of the fresh lesions and consisted almost exclusively of T cells (CD3 positive lymphocytes). In b.P., the discrepancy between a decreased number of CD2 positive lymphocytes (10-20%) and markedly higher number of CD3 staining cells (50-60% of all infiltrate cells) was striking. The characterization of the T cell subpopulations in both dermatoses showed mainly T helper cell infiltrates (CD4), while only up to 10% of T suppressor cells (CD8) were detected. CD45R positive (CD4+/CD45R+: suppression inducing) as well as CD29-positive (CD4+CD29+: cells which provide help for antibody production) T-cell subpopulations were detected in both dermatoses particularly adjacent to blister in up to 10% of the cell infiltrates. Epidermal staining with CD29 mab in b.P. up to the stratum spinosum and in P.v. within intraepidermal blisters was detected. By means of CD19 and CD21 mab B lymphocytes were minimal. Perivascular individual cell staining occurred with CD7 CD16, CD56 and CD57 mab (K/NK cells) in b.P. as well as in P.v. patients. The predominance in T cell infiltrates, particularly T helper cells, suggests the role of cellular immune mechanism in the pathogenesis of these diseases, in b.P. the CD2 antigen (SE receptor) appears to be of particular importance.

[Classification of HIV-associated acquired immunologic deficiency syndrome]. / Klassifizierung des HIV-assoziierten erworbenen Immundefektsyndroms.

Regarding the staging of HIV infection, there are several classification systems, but neither of them has universally been accepted. We tested a new staging system with 4 parameters: HIV antibodies, CD4/CD8 ratio, absolute count of CD4 + lymphocytes, and absolute count of leukocytes. This classification indicates a regular progression of immunodeficiency, 294 blood specimens were used for immunological staging. The correlation between the immunological staging and the severity of the disease proved the usefulness of this classification system.

[Epidermal reticular CD1 pattern]. / Das epidermale retikuläre CD1-Muster.

183 biopsies taken from various skin diseases as well as normal skin were studied in cryostat sections by means of the avidin-biotin complex immunoperoxidase technique, using monoclonal antibody anti-Leu 6, which is directed against the Langerhans cell antigen CD1. In 47 cases, we observed a reticular, pemphigus-like intercellular pattern. This pattern was neither correlated to individual skin diseases, nor to the quality or quantity of corial or epidermotropic infiltrates, nor to the HLA-DR expression of keratinocytes, nor to the count of Langerhans cells. There was, however, a correlation to the presence of Langerhans cells: This pattern was never observed in the aerosyringia or deep infundibula. We conclude, therefore, that the stained antigen has to be regarded as free CD1 derived from the Langerhans cell and diffusing into the keratinocytic intercellular spaces.

[Clinical and immunologic studies of the use of thymus polypeptide factor (thymostimulin) in chronic mucocutaneous candidiasis]. / Klinische und immunologische Beobachtungen während der Gabe von Thymuspolypeptidfaktor (Thymostimulin) bei chronischer mukokutaner Kandidose.

T-cell lymphocyte subpopulations were successfully converted by means of thymus polypeptide factor in a 17-year-old boy with chronic mucocutaneous candidiasis and combined immunodeficiency. It was demonstrated that the injections caused normalization of the peripheral T-lymphocytes subpopulations and a better state of general health. Normalization was due to a minimal increase in total peripheral T-lymphocytes and T-helper cells and a significant decrease in T-suppressor cells.

Simplified fixative medium for direct immunofluorescence in skin biopsies.

The main limitation for the use of direct immunofluorescence in skin biopsies was the necessity for frozen tissue. In 1973 Michel et al reported use of a liquid fixative, consisting of ammonium sulfate, N-ethyl-maleimide, magnesium sulfate, and potassium citrate, for handling skin biopsy specimens. The present study introduces a simplified liquid fixative medium consisting only of ammonium sulfate and saline. Comparisons of direct immunofluorescence findings in biopsy specimens transported in these two transport media and in fresh-frozen specimens revealed only minimal differences between the three different procedures.

[Mycotic mycetoma (eumycetoma) caused by Madurella mycetomi]. / Mykotisches Myzetom (Eumyzetom) durch Madurella mycetomi.

Mycotic mycetoma is a chronic, granulomatous and fistulous tropical disease caused by hyphomycetes of different families. A case caused by Madurella mycetomi is presented and the diagnostic and therapeutic possibilities discussed.

[Swimming pool granuloma--an atypical mycobacterial infection]. / Das Schwimmbadgranulom--eine atypische Mykobakteriose.

After an introduction on the problem of swimming pool or fish tank granulomas--chronic granulomatous skin infections with Mycobacterium marinum--we present two of our own cases. The disease is discussed and the signs and symptoms, histological changes, and therapeutic methodology presented.